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<p>Spinal hemangioblastomas (sHB) are rare vascular tumors, with distinct clinical courses between von Hippel-Lindau (VHL)-associated and sporadic cases. The MIB-1 labeling index has been proposed as a surrogate marker for tumor proliferation, but its prognostic value remains unclear in this context. In this subgroup analysis from a multicenter retrospective study, we analyzed 116 primary sHB patients with available MIB-1 indices. Patients were stratified by VHL status. Statistical comparisons included ROC analyses for local progression-free survival (PFS) prediction and Kaplan–Meier survival curves for local PFS, stratified by a MIB-1 index cut-off derived from Youden’s index. The MIB-1 index was significantly lower in VHL-associated tumors compared to sporadic ones (mean 2.17% vs. 3.02%, <i>p</i> = 0.008). In VHL-associated sHB, a higher MIB-1 index (≥ 2%) correlated with an increased risk of local tumor progression (AUC 0.74, 95% CI 0.49–0.98), whereas this was not observed in sporadic cases (AUC 0.56, 95% CI 0.23–0.88). Kaplan–Meier analysis showed that VHL patients with MIB-1 ≥ 2% had significantly shorter PFS (<i>p</i> = 0.05), while no significant association was found in sporadic tumors (<i>p</i> = 0.87). Our findings suggest that while VHL-associated sHB exhibit lower proliferative indices overall, elevated MIB-1 labeling indices might serve as a prognostic marker of shorter local PFS in this subgroup. In contrast, MIB-1 index appears to have limited prognostic relevance in sporadic sHB. These results highlight the importance of further molecular stratification and proliferation assessment in sHB to better inform clinical decision-making.</p> Graphical abstract <p></p>

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Prognostic relevance of MIB-1 labeling index in VHL-associated and sporadic spinal hemangioblastomas: a subgroup analysis from a multicentric study

  • 期刊论文

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  • 发表日期：

    2025年12月11日

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  • Johannes Wach,
  • Alim Emre Basaran,
  • Obada T. Alhalabi,
  • Jürgen Beck,
  • Vicki M. Butenschoen,
  • Steven D. Chang,
  • Marcus Czabanka,
  • Tomasz Czernicki,
  • Philipp Dammann,
  • Roberto Doria-Medina,
  • Sven Oliver Eicker,
  • Alonso Barrantes-Freer,
  • Christine Gizaw,
  • Erdem Güresir,
  • Marc Hohenhaus,
  • Romina Hohenhaus,
  • Ahed H. Kattaa,
  • Fatma Kilinc,
  • Lukas Klein,
  • Nikolaus Kögl,
  • Sandro Krieg,
  • Przemyslaw Kunert,
  • Maximilian Middelkamp,
  • Bernhard Meyer,
  • Nicolas Neidert,
  • Julia Onken,
  • Tobias Pantel,
  • David J. Park,
  • Laurèl Rauschenbach,
  • Roman Sankowski,
  • Alejandro N. Santos,
  • Nils Ole Schmidt,
  • Sebastian Siller,
  • Ulrich Sure,
  • Claudius Thomé,
  • Tarik Tihan,
  • Martin Vychopen,
  • Peter Vajkoczy,
  • Maria Wostrack,
  • Jan-Helge Klingler

摘要

Spinal hemangioblastomas (sHB) are rare vascular tumors, with distinct clinical courses between von Hippel-Lindau (VHL)-associated and sporadic cases. The MIB-1 labeling index has been proposed as a surrogate marker for tumor proliferation, but its prognostic value remains unclear in this context. In this subgroup analysis from a multicenter retrospective study, we analyzed 116 primary sHB patients with available MIB-1 indices. Patients were stratified by VHL status. Statistical comparisons included ROC analyses for local progression-free survival (PFS) prediction and Kaplan–Meier survival curves for local PFS, stratified by a MIB-1 index cut-off derived from Youden’s index. The MIB-1 index was significantly lower in VHL-associated tumors compared to sporadic ones (mean 2.17% vs. 3.02%, p = 0.008). In VHL-associated sHB, a higher MIB-1 index (≥ 2%) correlated with an increased risk of local tumor progression (AUC 0.74, 95% CI 0.49–0.98), whereas this was not observed in sporadic cases (AUC 0.56, 95% CI 0.23–0.88). Kaplan–Meier analysis showed that VHL patients with MIB-1 ≥ 2% had significantly shorter PFS (p = 0.05), while no significant association was found in sporadic tumors (p = 0.87). Our findings suggest that while VHL-associated sHB exhibit lower proliferative indices overall, elevated MIB-1 labeling indices might serve as a prognostic marker of shorter local PFS in this subgroup. In contrast, MIB-1 index appears to have limited prognostic relevance in sporadic sHB. These results highlight the importance of further molecular stratification and proliferation assessment in sHB to better inform clinical decision-making.

Graphical abstract